calcification AV, MV

82/F Patient history : dementia, cerebral infarction(10 years ago), hypertention Chest PA : cardiomegaly <img src="https://t1.daumcdn.net/cfile/cafe/19787B3A50B994481F" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_19787B3A50B994481F6E67"/> pic 1.  LVH with strain           cannot rule out lat-wall ischemia           ST segment elevation of ant wall   <img src="https://t1.daumcdn.net/cfile/cafe/0304B43A50B9944910" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_0304B43A50B994491092D4"/>  pic 2. AV calcification , LA 커져 있음.   <img src="https://t1.daumcdn.net/cfile/cafe/1909913A50B994490A" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_1909913A50B994490A7915"/>  pic 3. EKG 상 LVH와 ischemic 예상 되었다.           LVH 는 있었고. 다행히 wall motion 은 괜찮아 보였음.     <img src="https://t1.daumcdn.net/cfile/cafe/1262063A50B9944A34" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_1262063A50B9944A347655"/>  pic 4. SAX view 에서 wall thickness measure - septal 13mm, inferior - 13mm   <img src="https://t1.daumcdn.net/cfile/cafe/0201BE3A50B9944A13" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_0201BE3A50B9944A1334FA"/>  pic 5. SAX - AV valve (calcification NCC)   <img src="https://t1.daumcdn.net/cfile/cafe/1661103A50B9944A31" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_1661103A50B9944A31EB3B"/>  pic 6. AV planimetry ( 1.59 Cm2)   <img src="https://t1.daumcdn.net/cfile/cafe/1902263A50B9944B13" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_1902263A50B9944B13D51D"/>  pic 7. MV calcification (posterior leaflet)   <img src="https://t1.daumcdn.net/cfile/cafe/130B353A50B9944B08" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_130B353A50B9944B08774E"/>  pic 8. MR   <img src="https://t1.daumcdn.net/cfile/cafe/130DA53A50B9944B05" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_130DA53A50B9944B05C21F"/>  pic 9. LA volume - 57ml (enlarged)   <img src="https://t1.daumcdn.net/cfile/cafe/192A053450B9944B12" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_192A053450B9944B12C645"/>  pic 10. MV calcification ( 4CV, PLAX)             - 4 chambe view 에서 post. leaflet 이 안열리는 것 처럼 보였으나 zoom 해서 보니 열리긴 했습니다.   <img src="https://t1.daumcdn.net/cfile/cafe/151BA83450B9944C22" class="txc-image" style="FLOAT: none; CLEAR: none" actualwidth="580" border="0" hspace="1" vspace="1" width="580" id="A_151BA83450B9944C2222C7"/> pic 11. LV wall motion (compare with systolic and diastolic)   AVI file - 4CV view 에서 mitral posterior leaflet 안열리는 것처럼 보이나 아래 다른 scan position 에서 보시면              열리는 것을 확인 할 수 있습니다.   <iframe id="_hFEFUjvaIM$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/_hFEFUjvaIM$@my?service=daum_cafe&ptoken=v2_35163a3c5c0019d82df8c21524e4a94ee107fd85771102e2440fddec30ee691a4cc50e9b09c65f1a7e50fceec7934d6703be3040d4d661aba183b107" frameborder="0" scrolling="no" allowfullscreen></iframe>     <iframe id="mv62zzQw9Ic$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/mv62zzQw9Ic$@my?service=daum_cafe&ptoken=v2_db9c46980ebeda922adaf97dbf6c2e84e6490b9ecccc4708aafaef2c23a6419795535a64855aa68feaf2991119aba018929b840f258f71999e516b89" frameborder="0" scrolling="no" allowfullscreen></iframe>     <iframe id="SPww9YJtntA$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/SPww9YJtntA$@my?service=daum_cafe&ptoken=v2_6af7aa96e2a84f1c55c1f29f48a450e14dc57b725a7657e382cc4fa1b369f368df015efd87fe6ced2641a46ade7b4a339333d6e11737b593c4c9751d" frameborder="0" scrolling="no" allowfullscreen></iframe>   <iframe id="FFyBEi3oSg4$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/FFyBEi3oSg4$@my?service=daum_cafe&ptoken=v2_ab1ac205cb502e3a424e1a1fa31ba1738c4f6553242e442da89c4a9aef8e72a0b4f0f12ba4008cf698bca31657bbb221fe57d2d45dafaa3b70e43640" frameborder="0" scrolling="no" allowfullscreen></iframe>   <iframe id="hUL6uHXO5fQ$@my" width="640" height="360" src="https://kakaotv.daum.net/embed/player/cliplink/hUL6uHXO5fQ$@my?service=daum_cafe&ptoken=v2_3c66d77ac63dfb1e64d24f1987232c5df6aef6966b16b34ecd9185b5d6f35ec1d15ef86458ffff2daf6b16c5bd707a00a77af4d0d6f63d2820ee5401" frameborder="0" scrolling="no" allowfullscreen></iframe>